Provider Demographics
NPI:1083421721
Name:TOOTHZONE ORTHODONTICS PROFESSIONAL, LLP
Entity type:Organization
Organization Name:TOOTHZONE ORTHODONTICS PROFESSIONAL, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-223-8687
Mailing Address - Street 1:272 E 29TH ST # 274
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2733
Mailing Address - Country:US
Mailing Address - Phone:970-669-1122
Mailing Address - Fax:970-669-1984
Practice Address - Street 1:272 E 29TH ST # 274
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2733
Practice Address - Country:US
Practice Address - Phone:970-669-1122
Practice Address - Fax:970-669-1984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty